“The Death card usually depicts a skeleton, sometimes riding a horse but more often wielding a sickle. Surrounding it are dead and dying people from all classes, including kings, bishops and commoners. The reaper carries a black banner emblazoned with the Mystic Rose, which according to Waite symbolises life or rebirth.”
“In some decks, such as the AG Müller, the Wheel of Fortune is also attended by an individual wearing a blindfold; and often there are people sitting or riding on the wheel whilst others are shown falling from it.”
Azrael is a defected ankou with a somewhat shady vendetta against humans and their ability to do what he can’t. So he finishes the jobs big boss Death didn’t– forcibly ripping the souls from humans who were supposed to die, yet didn’t due to unforeseen circumstances, and were left unattended to. In this universe, forcibly removing a soul leaves the innards of the victim liquefied so it’s quite grisly, despite only being a spiritual element of the body. Violent or forced removal is a big no-no as not only does it make a mess, but it’s a horribly painful way to die.